Breast cancer

Breast cancer is cancer that starts in the tissues of the breast. There are 2 main types of breast cancer:

Ductal carcinoma starts in the tubes (ducts) that carry milk from the breast to the nipple. Most breast cancers are of this type.

Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk.

In rare cases, breast cancer can start in other areas of the breast.

The female breast is either of two mammary glands (organs of milk secretion) on the chest.

A needle biopsy is performed under local anesthesia. Simple aspirations are performed with a small gauge needle to attempt to draw fluid from lumps that are thought to be cysts. Fine needle biopsy uses a larger needle to make multiple passes through a lump, drawing out tissue and fluid. Withdrawn fluid and tissue is further evaluated to determine if there are cancerous cells present.

An open biopsy can be performed under local or general anesthesia and will leave a small scar. Prior to surgery, a radiologist often first marks the lump with a wire, making it easier for the surgeon to find.

Monthly breast self-exams should always include: visual inspection (with and without a mirror) to note any changes in contour or texture; and manual inspection in standing and reclining positions to note any unusual lumps or thicknesses.

Monthly breast self-exams should always include: visual inspection (with and without a mirror) to note any changes in contour or texture; and manual inspection in standing and reclining positions to note any unusual lumps or thicknesses.

Monthly breast self-exams should always include: visual inspection (with and without a mirror) to note any changes in contour or texture; and manual inspection in standing and reclining positions to note any unusual lumps or thicknesses.

Lumpectomy is a surgical procedure performed on a solid breast mass to determine if it is malignant. The suspicious lump and some surrounding tissue is excised and analyzed.

The female breast is composed mainly of fatty tissue interspersed with fibrous or connective tissue. The circular region around the nipple is often a different color or pigmented. This region is called the areola.

The female breast is composed mainly of fatty tissue interspersed with fibrous or connective tissue. The circular region around the nipple is often a different color or pigmented. This region is called the areola.

Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastisized), or is contained locally. When a cancer has been detected, often the next step is to find the lymph node closest to the tumor site and retrieve it for analysis. The concept of the sentinel node, or the first node to drain the area of the cancer, allows a more accurate staging of the cancer, and leaves unaffected nodes behind to continue the important job of draining fluids. The procedure involves the injection of a dye (sometimes mildly radioactive) to pinpoint the lymph node which is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, including lung and skin (melanoma).

Causes

Breast cancer risk factors are things that increase the chance that you could develop breast cancer:

Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control.

The more risk factors you have, the more your risk increases. But, it does not mean you will develop cancer. Many women who develop breast cancer do not have any known risk factors or a family history.

Understanding your risk factors can help you know how to prevent breast cancer.

Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct link between breast cancer and pesticides.

Of all the different types of cancers, breast cancer is one of the most talked about, and with good reason. One out of every eight women will develop breast cancer sometime in their life. That's why every woman should be thinking about how to protect herself from this disease.
Breast cancer is cancer that forms in the breast. Usually, it begins in the tubes that transport milk from the breast to the nipple. If the cancer spreads to other parts of the breast or body, it's called invasive breast cancer. Some breast cancers are more aggressive, growing more quickly than others.
Although women are 100 times more likely to develop breast cancer, men can also get the disease because they do have breast tissue. You're more likely to get breast cancer if you're over 50, you started your periods before age 12, or you have a close family member with the disease. Drinking more than a couple of glasses of alcohol a day and using hormone replacement therapy for several years also may increase your risk.
The telltale sign of breast cancer is a lump in your breast or armpit. You may also notice a change in the shape, size, or texture of your breast, or have fluid coming from your nipple when you're not breastfeeding.
If you notice any changes in your breasts, call your doctor. You'll probably need to have an imaging scan, such as a mammogram, MRI, or ultrasound. A piece of tissue may be removed from your breast, called a biopsy. With these tests, your doctor can tell whether you have breast cancer, and if so, determine whether or not it has spread.
So, how do we treat breast cancer?
That really depends on the type of cancer, and how quickly it's spreading. Your doctor may recommend that you have the cancer removed with surgery. Sometimes it's enough just to remove the lump. That's called a lumpectomy. In other cases, the doctor will need to remove the entire breast to get rid of all the cancer or prevent it from coming back. That's called a mastectomy.
Other treatments for breast cancer include chemotherapy, medicines that kill cancer cells, and radiation therapy, which uses energy to destroy cancer. Women whose cancer is fueled by the hormone estrogen may receive hormone therapy to block the effects of estrogen on their cancer.
Today's breast cancer treatments are better than ever. Many women who have breast cancer go on to live long, healthy lives. The outlook really depends on how fast the tumor is growing, and how far it has spread. That's why it's so important to report any changes in your breasts to your doctor as soon as you notice them. Women who are at an especially high risk for breast cancer because of their family history can talk to their doctor about taking medicine or even having surgery to reduce their risk.

Symptoms

Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don't have symptoms may be found earlier.

As the cancer grows, symptoms may include:

Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt.

Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange.

Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus.

In men, breast cancer symptoms include breast lump and breast pain and tenderness.

Symptoms of advanced breast cancer may include:

Bone pain

Breast pain or discomfort

Skin ulcers

Swelling of the lymph nodes in the armpit (next to the breast with cancer)

Weight loss

Exams and Tests

The health care provider will ask about your symptoms and risk factors. Then the provider will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area.

Women are encouraged to perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is debatable.

Tests used to diagnose and monitor people with breast cancer may include:

Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram

If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if the cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future.

Breast cancer stages range from 0 to IV. The higher the stage, the more advanced the cancer.

Treatment

Treatment is based on many factors, including:

Type of breast cancer

Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is)

Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery.

Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.

Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments.

After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer.

Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

New, improved treatments are helping people with breast cancer live longer. Even with treatment, breast cancer can spread to other parts of the body. Sometimes, cancer returns, even after the entire tumor has been removed and nearby lymph nodes are found to be cancer-free.

Some women who have had breast cancer develop a new breast cancer that is not related to the original tumor.

How well you do after being treated for breast cancer depends on many things. The more advanced your cancer, the poorer the outcome. Other factors that determine the risk for recurrence and the likelihood of successful treatment include:

Location of the tumor and how far it has spread

Whether the tumor is hormone receptor-positive or -negative

Tumor markers

Gene expression

Tumor size and shape

Rate of cell division or how quickly the tumor is growing

After considering all of the above, your provider can discuss your risk of having a recurrence of breast cancer.

Possible Complications

You may experience side effects or complications from cancer treatment. These may include temporary pain or swelling of the breast and surrounding area. Ask your provider about the possible side effects from treatment.

When to Contact a Medical Professional

Contact your provider if:

You have a breast or armpit lump

You have nipple discharge

After being treated for breast cancer, call your provider if you develop symptoms such as: